The Anxieties of a Child and Those of a Parent

My son is 10 and he is very fearful and anxiety prone. He is popular and well liked at school so he hides his fears there but at home he still doesn’t want to go to his room upstairs unless someone will go with him and about 1 night a week he can’t sleep because he lays awake with worries that he has trouble articulating. They just seem to be this vague sense of unease. He is doing well in school and he is generally a happy child, other than this anxiety and fear he deals with. I have been reluctant to take him to a psychologist because I think that once I do he will no-doubt come away with a label and then he will be labeled as having some type of mental illness. Do you think that it is urgent, given his age and the fact that he is generally happy, that we tackle this now. Can you recommend a book or give some advice on how I can help overcome his worrying? He is very intelligent and he is looking for me to tell him how to not worry and I feel like I am failing him that I can’t.

Rev. Christopher Smith Says...

It is difiuclt to be able to advise in your specific case, particularly as there are certain questions that are left open in what you describe. As such, I can only answer aout similar types of cases and encourage you to explore your particulars with someone in your are.

At the beginning of your account, you give some details about your son's behavior at school. The connection between being popular and well liked at his age and not having fears is not necessarily so clear. It is also not clear from what you described what fears your son would be hiding when at school. Even at home, it appears that his fears are very specific and do not overwhelm his whole expereince of life.

It would be interesting to know about things that happened before or around the time that he started having these problems. It is not clear whether he is experiencing general worries that are most prominent when he tries to go to sleep, whether he is afraid of his bedroom or something in it or whether his fears are more connected with sleeping. Of course, there are ways of working this out, but the question as posed is pretty hard to determine which would in fact be the case. Each of these could have very different root causes and would then want to be looked at differently. For example, if it is general anxiety being aplified at nighttime, which could be normal for a pre-adolescent who may be facing changes in his environment as he ages, then there are techniques that could be used to ease these anxieties. Also, if it is general anxiety and other techniques don't work, there are other alternatives that a mental health team could utilize, although they would not be the first line of attack for someone his age. On the other hand, if it is his room that is the source and for example this came from a movie that he watched, there are ways to talk through the differences between the movie an reality and to help him beyond fears of things that are not likely. As a final example, if it is about sleeping there are a number of things that could be behind this and one of them might be a fear of dying, especially if euphanisms about sleeping were used to describe someone he knew that died.

You may need to use a mental health professional to help you get to the bottom of this if he is not able to express his fears and anxieties to you. The mental health professional does not have to be a psychologist but could also be a masters level clincian (social worker, mental health counselor, marriage and family therapist, etc) or even a school counselor. Unless being done through school, you would likely be using your insurance or your employee assistance program to help pay for the sessions. If you do this, the mental health professional will have to provide a diagnosis. However, insurance companies and the whole system do not require this diagnosis to be something that is a life-long serious mental illness. There are diagnoses (such as adjustment disorder with anxiety or bereavement) which are by their nature not necessarily expected to be life-long. In any case, stigma around mental illness is decreasing in our society and many family and consumer groups would state that it is better to be labelled and getting help for what is going on than to not be labelled and to continue to suffer. In the case of anxiety disorders, a 2005 study (Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (June 2005). "Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication". Arch. Gen. Psychiatry 62 (6): 593–602. ) found that 29% of people in the UNited States suffer from an anxiety disorder at some point in their life , with 11-18% adults having a current anxiety disorder in a given year. If your son was diagnosed, he would be fitting along with about a third fo the population and there is hope that he could erturn to a place of peace and wholeness in his life.

As you seek to discern what to do in this situation, I wish you well. As you take time to think, I would encourage you to decide on a course of action sooner rather than later. Losing a night of sleep each week will have a toll on your son's physical and mental health and could end up having an impact on other parts of his life including school and social circles that are currently working well. It is also possible that an untreated anxiety disorder (if that is what he has) could draw out other related disorders. At the minimum, I would try to involve his school counselor in what is going on. If you are particularly concerned about possible labels still, you could seek help through your work's employee assistance program (as these programs are short term and thus more likely to utilize situational diagnoses unless a referral for further treatment was needed) or a professional in private practice that you can afford to go to on a cash basis and thus not generate any diagnosis trail. This is not soemthing that I would be really concerned about but you have to judge your own comfort level.